Dizziness and Neck Pain: A Perspective on Cervicogenic Dizziness

Cervicogenic dizziness is a somewhat controversial topic, as this condition is often considered a diagnosis of exclusion without a specific objective standardized test across health-care professions. The muscles of stability in the cervical spine are thought to have efferent connections to the vestibular nuclei and help to give additional information about an individual’s posture, place in space, and sway. Animal models have shown disequilibrium and nystagmus with manipulation of these muscles.

These models support the importance of cervicogenic information as part of the larger proprioceptive equilibrium system. As such, one might expect dizziness and/or disequilibrium with an injury or damage to the cervical spine. In an article written by Hertogh et al. (2025), an attempt is made to explore further the pathophysiology, diagnosis, and treatment of this condition.

According to the authors, the proprioceptive system in the cervical spine may be influenced by pain. In research subjects, induced neck pain resulted in reduced sensorimotor control. This seems to reflect a different mechanism for cervicogenic dizziness than asymmetrical output from each side of the neck with a unilateral neck injury.

There are many tests for cervicogenic dizziness, which all seem to have variable sensitivity and specificity, are based on small study subject groups, or are not supported across studies. As such, additional research is needed to form a standardized test paradigm assessing cervicogenic dizziness. It is important for audiologists making this diagnosis to understand the limitations of tests for cervicogenic dizziness and importance of careful history taking.

Reference

De Hertogh, W., Micarelli, A, Reid, S., Malmastrom, E, Vereeck, L, & Alessandrini, M. (2025). Dizziness and neck pain: a perspective on cervicogenic dizziness exploring pathophysiology, diagnostic challenges, and therapeutic implications. Frontiers in Neurology, 16, 1545241.